GI illnesses account for substantial clinical and economic burdens on US emergency medical services.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. If diagnosed early, curative treatment options such as surgical resection, loco-regional therapies, and liver transplantation are available to patients, increasing their chances of survival and improving their quality of life. Unfortunately, most patients are diagnosed with late stage HCC where only palliative treatment is available. Therefore, biomarkers which could detect HCC early with a high degree of sensitivity and specificity, may play a crucial role in the diagnosis and management of the disease. This review will aim to provide an overview of the different biomarkers of HCC comprising those used in the diagnosis of HCC in at risk populations, as well as others with potential for prognosis, risk predisposition and prediction of response to therapeutic intervention.

Background: Long-segment posterior fixation has been used as a mainstay treatment of spine fracturedislocations. Studies using short-segment posterior fixation in cases of thoracolumbar fracture-dislocation are limited. We describe our experience of 26 patients with thoracolumbar fracture-dislocation treated by short-segment or longsegment posterior spinal fixation and fusion.Methods: This is a single-center retrospective study of 26 patients with thoracolumbar fracture-dislocation treated by long-segment (group 1, n ¼ 12) and short-segment posterior instrumentation (group 2, n ¼ 14). Clinical (visual analog scale [VAS], Oswestry Disability Index [ODI]), neurological (American Spinal Injury Association [ASIA] scale), radiological (kyphotic angle, translational percentage, and displacement angle), and surgical (blood loss, operative time) outcomes and complications were recorded with each method. The mean follow-up period was 8.64 months (6-20 months).Results: The mean duration of surgery was 3.92 6 0.67 hours in group 1 and 3.21 6 0.54 hours in group 2, and mean blood loss was 583.33 6 111.5 mL and 478.6 6112.2 mL in groups 1 and 2, respectively (P , .05). There was no radiologically visible pseudarthrosis, implant failure, or screw breakage in either group at follow up with no statistically significant difference between the 2 groups with regard to the radiological outcome (P . .05). Two patients in group 1 and 6 patients in group 2 improved after surgery at least 1 ASIA grade. VAS and ODI improved in both groups at the final follow up.Conclusions: Short-segment fixation can be used for treating fracture-dislocation patients, as it results in less blood loss, decreased intraoperative time, and saves fusion segments with similar radiological and clinical outcomes as longsegment fixation.

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A prospective survey of all telephone calls for medical advice to the Accident & Emergency Department of Leicester Royal Infirmary was undertaken. The objectives of the study were to quantitate the frequency and circumstances related to these inquiries. Over the study period of 10 days, details of 154 telephone calls were recorded. The results demonstrated the perception of the general public, that the A & E department was the most logical place to contact. Only 30% (46) attempted to seek advice from their general practitioner prior to calling the department.

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